We live in a golden age of opportunity to make the most of the NHS’s best attributes abroad and improve the service at home, says Sue Day

NHS at the Olympics opening ceremony

Despite its name the NHS is a global brand. Whether it is celebrated in front of a worldwide audience at the Olympics or denigrated by US politicians, it is in the sphere of awareness of much of the planet.

‘Those with concerns cite the distraction factor − that trust executives will be distracted from the day job’

In the context of a time when the NHS is facing greater financial challenges than at any time in its history, it is not a surprise to hear talk about taking the brand overseas.

The government aims to encourage such expansion as a way to generate additional income and together the Department of Health and the UK Trade and Investment Department are taking messages about the NHS’s capabilities, achievements and expertise to trusts and overseas governments

Overseas expansion has concerned some patient groups worried about the possibility of a resultant fall in the standard of care in the UK, while those who champion the idea talk up the potential financial and quality benefits to NHS organisations. But who is right?

Chasing opportunities

Those with concerns cite the distraction factor. They argue that if trust executives and top clinicians are spending their time overseas chasing and delivering these opportunities they will be distracted from the day job.

‘With so many reasons to go for it, it is simply too good an opportunity for forward-thinking trusts to miss’

Similarly, if top clinicians are spending time on overseas projects then quality standards in the UK may fall as their work is backfilled by less experienced staff. These arrangements are also likely to lead to greater numbers of overseas patients being brought to the UK, especially for complex, specialist procedures. Could this mean UK-based patients are bumped down the priority list?

It goes without saying that if trusts do not pursue these overseas opportunities they will not face these distractions. But it isn’t that simple, and questions must be asked about what else they might be missing.

In its starkest terms, the burning questions should be around what opportunities exist for an NHS trust looking at potential overseas expansion?

Best of the best

For one thing, the strength of the world-renowned NHS brand gives trusts a head start when it comes to pursuing the multitude of opportunities beginning to open up in the Middle East and Asia.

It means they have the opportunity to take their knowledge overseas and earn a premium for sharing that expertise, educating local clinicians to help save the lives of local people. The profits go back home for the trust to invest in improving services for NHS patients.

Overseas expansion also broadens the base of experience of clinicians, giving them the opportunity to treat different types and mixes of illness and, at the truly specialist end, simply giving them more exposure to rare and complex conditions. 

Similarly, the boundaries of research are opened up, potentially increasing research populations and expanding the number of minds available to input into that research.

All of this spells out exciting and challenging opportunities for individual clinicians and scientists, giving trusts an additional string to their recruitment bows.  In an environment where skilled clinicians are at a premium, it can enable trusts to attract the best of the best.

Move with the times

It seems that with so many reasons to go for it − all of which directly or indirectly should benefit NHS patients − it is simply too good an opportunity for forward-thinking trusts to miss. Yet, to make it work, they must put in place important safeguards to make sure distractions from the day job are managed.

For example, sufficient resourcing at senior level must be factored into the equation to enable rigorous oversight of home provision and of pursuit of overseas opportunities.

Careful planning and recruitment of sufficient and appropriately qualified medical staff has to be a priority to meet demand both at home and overseas.

‘We live in a global age of opportunity and expansion across borders’

Simple criteria needs to be in place to ensure NHS patients are not treated unfairly in comparison to those “imported” from abroad. Importantly, risk and evaluation mechanisms that enable trusts to assess opportunities should be developed so, where appropriate, there is justification to decline the opportunity to expand abroad.

With such safeguards, trusts can pursue opportunities that will enable them to improve the provision received by NHS patients, not detract from it.

We live in a global age of opportunity and expansion across borders. If the NHS can move with the times it has the chance to generate investment and improve standards at home.

At the same time, it can take the qualities that make the NHS so great to places where healthcare is not as well developed. Doing so will ensure the NHS can improve quality of life and healthcare in those places too.

In short, ensuring the NHS remains true to its core values and to what it has always stood for as a brand.

Sue Day is associate director at KPMG Healthcare Practice